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NPI 1205503661

NPI 1205503661 : MARCIA BREMENOUR LPCC, INC. : MAYFIELD HEIGHTS, OH

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General NPI Number Information
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    NPI Number           |    1205503661
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    Entity Type          |    Organization 
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    Legal Business Name  |    MARCIA BREMENOUR LPCC, INC. 
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Dates
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    Enumeration Date     |    08/24/2021
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    Last Update Date     |    08/24/2021
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Provider Practice Location Address
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    Address Line         |    6120 PARKLAND BLVD STE 210 
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    City                 |    MAYFIELD HEIGHTS
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    State                |    OH
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    Zip                  |    44124-6129
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    Country              |    US
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    Telephone            |    440-376-7736
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6120 PARKLAND BLVD STE 210 
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    City                 |    MAYFIELD HEIGHTS
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    State                |    OH
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    Zip                  |    44124-6129
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    Country              |    US
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    Telephone            |    440-376-7736
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OFFICER
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    Name                 |    MRS. MARCIA J BREMENOUR 
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    Credential           |    LPCC
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    Telephone            |    440-376-7736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    
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    License Number State |    
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